HomeMy WebLinkAboutR 2018-082 AMS - Environmental Solutions Group site assessment and sampling 129 E KingRevised 10/17
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Environmental Solutions Group (ESG) Party/Vendor Contact Person: Dan Whitaker
(dwhittaker@go-esg.com) Contact Phone: 336-373-1538 Party/Vendor Address: 100 N. Elm Street City
Greensboro State: NC Zip: 27401 Department: AMS Amount: $1,725.00 Purpose: Full Site Assessment, Air &
surface sampling for remediation at 129 E. King Street Budget Code(s): 10240320-570000 Vendor # 65016 (N/A
if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal
Amendment Effective Date 3/8/18 Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ Date: ________
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer___________________________________ Date: ________
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: E52B8315-AFE6-4DB3-8A28-FA045C18AA31